MEDICARE: AUBREY DICKMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	50391	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	J0465601	OTHER	MA	MEDICARE FOR CAMBRIDGE HEALTH ALLIANCE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447229810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUBREY DICKMAN MD

Provider Business Mailing Address
First Line	:	3 WOODLAND RD
Second Line	:	SUITE 421
City	:	STONEHAM
State	:	MA
Zip	:	02180-1702
Country	:	US
Telephone Number	:	781-665-2525
Fax Number	:	781-665-1207

Provider Business Practice Location Address
First Line	:	3 WOODLAND RD
Second Line	:	SUITE 421
City	:	STONEHAM
State	:	MA
Zip	:	02180-1702
Country	:	US
Telephone Number	:	781-665-2525
Fax Number	:	781-665-1207

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	06/23/2010

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Directions to “ AUBREY DICKMAN MD” Practice Location

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